Mifepristone when given in bi-weekly doses was found to be safe, efficacious, and cost effective as compared to treatment with tranexemic acid and mefenemic acid for management of fibroid uterus.

Chronic inversion of uterus is a rare clinical entity which is usually associated with obstetrics complication and rarely with gynaecological disorder like fibroid present at fundus of uterus. We here present a case of 40-year-old female P3L3 with chronic inversion of uterus with fundal fibroid which present with 3year history of abnormal vaginal bleeding. Ultrasonography and MRI revealed cervical fibroid. Due to AUB secondary to cervical fibroid decision of hysterectomy was taken. On laparotomy chronic uterine inversion was present which was corrected by haultain’s procedure. Then hysterectomy was done. Histopathology report suggestive of uterine leiomyoma at fundus of uterus. Chronic uterine inversion associated most commonly with fundal submucous leiomyoma. Other causes are leiomyosarcoma, endometrial carcinoma, cervical carcinoma, rhabdomyosarcoma, mixed mullerian sarcoma. It is an extremely rare gynaecological condition and can be misdiagnosed as cervical fibroid, advanced cervical malignancy or other causes of AUB in females. It could be labelled as gynaecological near miss so a high index of suspicion is necessary for it’s diagnosis.

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Background: Uterine leiomyomas are the most common benign tumours of the uterus and also the most common benign solid tumor in female. It arises from the uterine smooth muscles (myometrium) but contain varying amount of fibrous connective tissue. Aim of study was to evaluate the efficacy of very low dose Mifepristone (10 mg) on leiomyoma volume and its related symptoms. Methods: This was a prospective clinical study. 30 women met with the inclusion criteria and giving informed consent for the study. Results: Mean myoma volume was 60.32±51.89 at initial visit and 36.13±48.54 at 3 months follow up visit with 40.1% reduction which was statistically significant difference (p < 0.001). Mean PBAC score in Group I was 155.53±21.70 at initial visit and 0.97±2.97 at 3 months follow up visit with 99.3% reduction which was statistically significant (p < 0.001). Conclusions: Mifepristone 10 mg is efficacious in term of control of bleeding, alleviation of pain related symptoms with few side effects. So low dose mifepristone can be used as a suitable option for women with symptomatic fibroids in perimenopausal periods or patients not willing or fit for surgery.